[Management of acute empyema with leakage of bronchial anastomosis after right sleeve upper lobectomy--a case report].
Bronchopleural fistula developing empyema after pulmonary resection is a fatal complication. But we have successfully treated this complication after right sleeve upper lobectomy. The patient was a 61-year-old male, who has a squamous cell carcinoma originating in the right upper lobe of the lung in the clinical stage of IIIa. Right sleeve upper lobectomy with pericardiotomy to reduce the tension of bronchial anastomosis and R2a lymph node dissection. The leakage of bronchial anastomosis was complicated on 5th postoperative day and developed aspiration pneumonia of right middle and lower lobe and empyema. Reoperation was done on 7POD and completion pneumonectomy, omentopexy and open window thoracotomy were performed. Then endotracheal tube had been inserted into the left main bronchus and he controlled under respirator. Six weeks after that fistula was cured. Empyema, which caused by methicillin resistant staphylococcus aureus, was cured by open drainage for 2 weeks and closed drainage and irrigation for 14 weeks. He discharged 16 weeks after reoperation.
Kondo
D
D
Department of Thoracic Surgery, Nagoya University School of Medicine, Japan.
Imaizumi
M
M
Ojika
T
T
Watanabe
H
H
Uchida
T
T
Abe
T
T
D000714:Anastomosis, Surgical; D001980:Bronchi / Q000601:surgery*; D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004322:Drainage; D004653:Empyema / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D013529:Surgical Wound Dehiscence / Q000601:surgery*; D007507:Therapeutic Irrigation